Some Basic ConceptsEFFICIENCY: Cost for each outcome unitOUTCOME MEASURES: .EFFECTIVE: Outcomes in an experimental situationEFFECTIVENESS: Outcome under real conditionsUTILITY:Outcomes expresed considering time and Quality of Life.BENEFIT: Outcome evaluated in terms of money.HEALTH QUALITY: How much efectiveness is closer to effectiveEVALUATION OF CLINICAL PRACTICE:SAFETY: reducing the riskEFICACYEFECTIVITYUTILITYBENEFITEFICIENCYEQUITY24/11/12 Alberto Ruiz CanteroMálaga
II Workshop Foro Osler. November 2012• Conference Dr.Alberto Ruiz Cantero, Head of Internal Medicine, Hospital de la Serranía, Ronda, Málaga, titled: General actions heading to Diagnostic Process Improvement• SUMMARY: Some general concepts about improving techniques from the Industry (Lean and Six Sigma) and more medical initiatives such as “Chossing Wisely” and NICE
lean manufacturing• Lean is a production practice that considers the expenditure of resources for any goal other than the creation of value for the customer to be wasteful, and thus a target for elimination.• Value: any action or process that a customer would be willing to pay for.• Lean basically is everything around to do the proper thing, at the proper place and moment, with the amount correct, trying to eliminate waste and,at the same time, being flexible and open to changes.• Do you find a meaning for that in clinical practice? I,M sure yes: considering time, asking for the proper test, reducing waste and in Medicine also reducing risk for the patient. 24/11/12 Alberto Ruiz Cantero Málaga
Six Sigma: concept• Continuous efforts to achieve stable and predictable process results (reduce process variation)• Process have characteristics that can be measured, analyzed, improved and controlled.• Commitment from the entire organization
Six Sigma procedures• Define the problem• Measure key aspects• Analyze data• Improve or optimize the current process• Control the future state process to ensure that any deviations from target are corrected before they result in defects.